General Medical issues thread

[andye]

I find that some of my more 'sheltered' junior doctors attribute all sorts of medical admissions as entirely due to alcohol when the actual amounts are quite modest and there is an alternative explanation.
Conversely, I have seen many older people presenting with levels over 0.2 despite seeming sober and claiming only a glass or two

 

[prozac]

My hips are getting worse. A lot on my mind. And yes most importantly no injury.

LOL @prozac. Alcohol had nothing to do with it. One of the guys in the group was behind me and noticed that my right side (hip) gave way which made me lose balance. I was laughing because I fell into the hedge and that shielded my fall and avoided any injury.

Note this was around 2:00pm and I was still drinking until midnight when we got back to bar.

P.S. One of the things that's changed and scares me is legs/feet give way at times. Say I'm standing at lights or side of the road and start to walk and stumble as the first step is not stable. I'm not sure if that's hip, knee or feet. I need to be careful and take zero risk if cars are coming.

Note this happens randomly and definitely no alcohol involved as I do not drink alcohol in Australia.

No malice intended John. The explanation was in itself, funny. Maybe it's a muscle memory issue. After a work injury decades ago I could not lift my left lower leg to step over things. Physio reckoned it was something to do with muscle memory with my quad simply not switching on when it should have.

 

[Pushka]

I find that some of my more 'sheltered' junior doctors attribute all sorts of medical admissions as entirely due to alcohol when the actual amounts are quite modest and there is an alternative explanation.
Conversely, I have seen many older people presenting with levels over 0.2 despite seeming sober and claiming only a glass or two

And as a former Police Officer I’ve seen people pulled over claiming to have had only one or two drinks when their test results and behaviour suggests otherwise. The worst was a guy asleep at the wheel at an intersection around 11pm. It’s impossible to gauge the actual impact just a couple of drinks have given issues like heat, exercise, food intake and so on.

But as you say alcohol can be blamed when the cause lies elsewhere.

 

[JohnK]

No malice intended John. The explanation was in itself, funny. Maybe it's a muscle memory issue. After a work injury decades ago I could not lift my left lower leg to step over things. Physio reckoned it was something to do with muscle memory with my quad simply not switching on when it should have.

I know mate and I took it as a joke.

The hard part with this one is we may never find out why this is occurring.

Also it's not just one issue but many issues and not easy to give any issue more focus than others. I remember when I used to go to physio we'd be working in one area and then another area had issues. Start working on that area and the original area becomes a problem again.

I can handle pain but don't know what to do when one of the legs gives way.

 

[Himeno]

I find that some of my more 'sheltered' junior doctors attribute all sorts of medical admissions as entirely due to alcohol when the actual amounts are quite modest and there is an alternative explanation.
Conversely, I have seen many older people presenting with levels over 0.2 despite seeming sober and claiming only a glass or two

I've had some hospital visits where I tell them (after they ask) that I don't drink, smoke or take drugs (besides what I might get prescribed) and they claim I'm lying. I've had less alcohol in my entire life than JohnK had at that golf course before his fall.

 

[tgh]

Last time I was interrogated about alcohol in a hospital setting, I told them precisely how much I consume.
During some further conversations with doctors the subject was mentioned in a way that led me to believe they thought I had a problem.
Subsequent social conversation with someone in the know said that they often write down double whatever people tell them.
It may not be universal though , as my dil ( who manages admissions in a large hospital) was a bit taken back.. we would never do that !

 

[Himeno]

At the hospital yesterday, the triage nurse recorded in my notes that the injury was on the right, not the left. Also didn't note that he gave me painkillers. Which lead to all sorts of confusion for the next shift (which was getting ready to hand over when I got there) when I started feeling light headed in the waiting room and called for some help. They had to do a stocktake of the painkillers in triage to confirm what/how much I had been given.

 

[andye]

Last time I was interrogated about alcohol in a hospital setting, I told them precisely how much I consume.
During some further conversations with doctors the subject was mentioned in a way that led me to believe they thought I had a problem.
Subsequent social conversation with someone in the know said that they often write down double whatever people tell them.
It may not be universal though , as my dil ( who manages admissions in a large hospital) was a bit taken back.. we would never do that !

I dont think writing down double happens but there is scepticism about self-reports.

Last night at the dinner table, I was discussing a little feisty old lady who had fallen after 3 drinks that all and sundry were saying was an alcoholic ( I thought not). My 13 yo was sure she was lying.

One of the issues is that the drinking guidelines are based on the actuarial figures leading to longest possible life. People who run into major direct alcohol health issues are usually drinking multiples of these. Acute inebriation has its own dangers of course.

 

[prozac]

... My thought today was maybe a nerve was damaged and this is the source of the chest pain running up the neck and into the ear. Who's good with anatomy of nerves? Care to comment either here or by DM?

No opinions that this pain could be nerve damage in the chest from the thoracic procedure? I am running out of tolerance and cardio doesn't have any answers. Heart ultrasound looks as expected but does not answer why I have this amount of pain.

 

[JohnK]

I dont think writing down double happens but there is scepticism about self-reports.

So if I told you my last drink was 08/Oct/25, next drink will be 28/Mar/26 and I will stop drinking again on 16/Apr/26 you would not believe me?

 

[andye]

So if I told you my last drink was 08/Oct/25, next drink will be 28/Mar/26 and I will stop drinking again on 16/Apr/26 you would not believe me?

I'd believe you. Some health professionals who dont know you from Adam might not.

My natural tendency is to trust unless the picture doesnt fit and it matters to the diagnostic/treatment process.

I dont see it is my mission to demand my patients follow all public health advice to the letter. It's up to the individual how they look after themselves as long as they are aware of the correct info. Happy to suggest strategies if they want to change things though